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SITE ADDRESS <br />LEGA LOT NO. <br />DESC. <br />OWNER <br />�w•�e vo <br />PERMIT APPLICATION <br />CITY OF EVERETT PERMIT SERVICES <br />3200 CEDAR o fREET, EVERETT, WA 98201 <br />425-257-8810 — FAX 425-257-8857 — www.everettwa.org <br />APPLICATIONS ARE ACCEPTED FROM 8 AM TO 4 PM ��- .. g_� <br />BLOCK <br />PARCEL TAX I.D. X <br />TRACT OR SUBDIVISION R <br />PERMIT�^I� / <br />/� � I l " � \ <br />Zz-$-'�R18 <br />TENANT NAME CONTACT FOR PERMR PHON � �/� <br />I -i1w�� VO rq�t � -AANL g - <br />A,� �ucfod �-� . 4 ii� 4�l sr P l N�= �rv�z� � �.970 - <br />� _ �,� V^�ws..l r, 38zs <br />COhTR. LICENSE N �, � <br />e.-r.vNi�i-f�i27 Ai3 1•�'-' cjPj27t7 <br />USE OF BUILUING <br />��� <br />WORK DESCRIPTION <br />�L�I�.C2 `e 1�• 5 -�'"� <br />N0. I TYPE OF FlXTURE OR REM <br />Toilet <br />Balhtub <br />Lavatory (wash basin; <br />Shower <br />Kitchen sink & disposal <br />Oishwasher <br />Clothes washer <br />Water heater <br />Sir,k (service/bar/mop�etc.) <br />8ackflow preventer <br />Urinal <br />Drinking Founlain <br />Floor drain <br />Crease trap <br />Roof drains <br />Other <br />Electric �Gas_Olher <br />.�a5 t�i.�kFC�I <br />CONTRACT PRICE OF WORK <br />� SZC. �r' <br />NO. I TYPE OF FI%TURE OR ITEM <br />A/C - air handling units <br />� Fo�ced air sys!ems <br />Gas piping <br />1Nater heater <br />Gas fireplace <br />Gas range <br />Clothes dryer <br />Rangehood <br />Exhaustfan <br />Heat pump <br />Unit heater <br />Boiler <br />Refrigeration <br />Woodstove <br />CITV OF EVERETT LOCAL SALES TAX CODE IS 3105 <br />I hereby ceritity Ihat I have read and ezamined tnis applicalion and know Ihe same to be true and cortect. All provisions of laws and <br />ordinaces governing ihis type of work will be complied with whether specitied herein or not. The granting ot a permit dces not presume <br />to give authority to violat� or cancel the provision ot any o�her state or local law regulating construction or the performance of <br />construction. That I am authorized by �he owner of ihis property lo perform the work (or which application is made and I comply xn`th the <br />State Coptractors Law 1827 RC1p'�nd 296200 WAC. <br />